Court Review of Pharmacy Degree Program Accreditation

A school of pharmacy files a preliminary injunction when the Accreditation council for Pharmacy education places the institution on probation.

Issue of the Case
Action by the Accreditation Council for Pharmacy Education (ACPE) placing the pharmacy degree program at a school of pharmacy on probation with regard to its accreditation status led to the institution seeking a preliminary injunction in a federal district court. Is that remedy available and proper in this situation?

Facts of the Case
Institutions accredited by the ACPE to offer the Doctor of Pharmacy degree program must meet a number of standards published by the organization to be accredited. Degree program accreditation is important for a number of reasons, not the least of which is the eligibility of graduates to sit for the pharmacy licensure examination and for students enrolled there to qualify to apply for federal student financial aid.

Typically, the ACPE will send a visitation team to the campus for an onsite assessment as well as seek periodic written submissions regarding changes and progress in addressing any concerns regarding compliance with the standards. The ACPE had warned this institution multiple times that the accreditation of its PharmD degree program was at risk because of a determination that it was not in compliance with 2 ACPE standards (Standard 24: Quantitative Faculty and Staff Factors and Standard 30: Financial Issues Related to Faculty Salaries).

Despite repeated admonitions that these issues needed to be addressed, the institution failed to satisfactorily rectify these shortcomings. As a result, the ACPE placed the degree program on probation until the perceived defects were corrected. Alleging violation of its due process rights, the institution filed for a preliminary injunction in the local US District Court. The institution was seeking to restrain the ACPE from publishing the probationary status of the program, to require the agency to provide objective standards to be met in order to obtain full accreditation, to rescind the probationary status determination, and to enjoin further revocation of accreditation for a 2-year period.

The Court’s Ruling
The preliminary injunction sought by the institution was denied.

The Court’s Reasoning
In order to determine whether entering an order of temporary injunction was appropriate, the court needed to balance the harm to the institution against the importance of the ACPE being able to discharge its role. The court’s focus was on the likelihood of irreparable harm to the institution should the injunction not be granted and, as a corollary to that, the likelihood of irreparable harm to the ACPE and its accreditation responsibilities. The court also examined the likelihood that the institution would prevail on the merits of the case once a full trial was held. Finally, the court weighed the interest of the public in this controversy.

Looking at harm to the institution, the court pointed out that it had succeeded in attracting several new faculty members despite the probationary label and possible loss of accreditation. Turning to the impact on the ACPE, the court recognized that granting the requested preliminary injunction had the possibility of compromising the ACPE’s accreditation activities. Nonetheless, the court concluded that such consideration was not sufficient in and of itself to deny the injunction.

Examining the probability that the institution would prevail on the merits, the court used the relatively low threshold of whether the school had no chance at all of succeeding on the merits. Concluding that there was some possibility that the institution might prevail, the court concluded that this element needed for a preliminary injunction had been met.

Finally, the court turned to whether entering the injunction would interfere with the ACPE’s enforcement of its standards, thereby adversely affecting the public health and safety. Emphasizing the role of the accrediting agency in “protecting the public from students or graduates whose educational experience did not meet certain minimum criteria,” the court stated that the case “necessarily also involves issues of life and death.”

Balancing all the foregoing competing interests, the court concluded that the institution would suffer irreparable harm if accreditation was withdrawn, and that it had “some chance of prevailing” with its due process claims. On the other hand, looking at the public interest represented by the ACPE’s program accreditation activities and its connection to “serious and substantial concerns regarding public health and public safety,” the judge concluded that, on balance, the injunction should not be entered. The “strong countervailing public interests at stake” outweighed the fact that the institution appeared to have fulfilled the prerequisites for a preliminary injunction.

Dr. Fink is professor of pharmacy law and policy at the University of Kentucky College of Pharmacy, Lexington.

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